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Robot-assisted laparoscopic continent cutaneous urinary diversion in adults: A single-centre study
Thomas Loubersac1,2, Etienne Lavallée3, Benédicte Reiss4
1Department of Urology and Pediatric Urology Nantes Université, Centre Hospitalo-Universitaire de Nantes Nantes France.
BJUI Compass
|January 2, 2025
Summary
Robot-assisted laparoscopic cutaneous continent urinary diversion (RALCCUD) is a feasible and safe procedure in adults. This study shows a 100% continence rate and low complication rates, supporting its clinical utility.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Reconstructive Surgery
Background:
- Data on clinical outcomes for robot-assisted laparoscopic cutaneous continent urinary diversion (RALCCUD) in adults is limited.
- RALCCUD is a surgical technique for urinary diversion, but its efficacy and safety profile in adult populations require further investigation.
Purpose of the Study:
- To evaluate the feasibility, safety, and clinical outcomes of robot-assisted laparoscopic cutaneous continent urinary diversion (RALCCUD) in adult patients.
- To assess functional outcomes, including self-catheterization capability and continence rates, following RALCCUD.
Main Methods:
- A retrospective study was conducted on adult patients who underwent RALCCUD between 2017 and 2022.
- Patient characteristics, operative details, perioperative outcomes, and functional results (evaluated via urodynamics and follow-up) were recorded.
- Continence was defined as the absence of stomal or urethral leakage.
Main Results:
- Twelve adult patients (11 female, median age 47.4 years) underwent RALCCUD for various diversion types, primarily due to inability to self-catheterize via the native urethra.
- The majority of patients (92%) had neurogenic lower urinary tract disease. Concomitant procedures included cystectomy, augmentation cystoplasty, and artificial urinary sphincter placement in some cases.
- The study reported a 100% self-catheterization rate and 100% stomal and urethral continence at last follow-up, with one early (Clavien grade III) and three late (17%) postoperative complications.
Conclusions:
- Robot-assisted laparoscopic cutaneous continent urinary diversion (RALCCUD) is a feasible and safe surgical option for adults requiring urinary diversion.
- The procedure demonstrates high rates of functional success, including excellent continence and self-catheterization capabilities.
- RALCCUD is associated with a low overall complication rate, making it a viable treatment option for complex lower urinary tract dysfunction in adults.
